Note: This form should be completed only after you have a fully executed letter of agreement with Dr. Gustavo.
In order for Dr. Gustavo to work most effectively with you at your meeting/program/event, we request that you complete the following form. The information collected serves to customize the presentation and ensure your needs are met. When you engage us, we become part of your team!
Please answer all the questions as completely as possible. Please use N/A for questions that you believe do not apply and TBD for items that have not yet been determined.